Job description
Title: Operations Quality Analyst
Location: Newtown Square, PA 19073
Job Description:
The primary purpose of the Operations Quality Analyst is to provide high level technical expertise and analysis to the Coordination department. They will work closely with configuration, PDM and the Plans to identify root cause and drive to resolution.
- Function as a key subject matter expert
- Have experience in auditing and quality review specific to service coordination activities.
- Maintain a current working knowledge of contractual guidelines, Plan policy and operational procedures to effectively provide subject matter expertise.
- Support the team in identifying issues for quick remediation.
- Assist in analysis of target audits as required.
- Ability to communicate and represent the team to the Enterprise, the health plan and outside auditors.
- Utilize various technology applications related to quality review data collection and analysis. (Excel/Access/Word)
- Identify audit trends and provide recommendations.
- Train any new QA staff
Skills:
- Extensive claim experience
- Strong understanding of facets applications
- Critical thinking skills
- Technically proficient
- Proficient in MS Excel and Word
COLLECTION DATA, COLLECTION OPERATIONS,QA,AUDIT
Education:
- Bachelor’s Degree needed
Job Type: Full-time
Pay: $30.00 - $32.00 per hour
Schedule:
- Day shift
- Monday to Friday
Education:
- Bachelor's (Preferred)
Experience:
- Data collection: 2 years (Preferred)
- Auditing: 1 year (Preferred)
- Microsoft Excel: 1 year (Preferred)
- Quality audits: 3 years (Preferred)
- Claims: 3 years (Preferred)
Work Location: Remote
Speak with the employer
+91 972-432-4016
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